One of the things my organization has always struggled with is the concept of professional development. Of course we require the physicians, nurses, and other licensed professionals to attain the required hours of continuing education in their respective fields. For all the other disciplines where it is not mandatory, we tend to do a relatively poor job.

Case in point: physicians and nurses who transition from clinical practice to administrative positions are no longer granted continuing education time or funding. Although we’re required to keep licensure, it’s up to us to do it on our own.

Those of us in the IT realm have come up with creative ways to earn our hours, such as attending sessions at our vendors’ user group meetings that have been granted continuing medical or nursing accreditation. Others teach medical students and residents or simply complete online continuing ed classes. While that meets the letter of the law, I’m not sure it does much for us as far as professional development.

Being a CMIO, CMO, or medical informaticist requires skills we weren’t born with. It is important to keep up with the constantly changing environment in which we work. It’s critical that people operating in those roles be allowed time and funding to attend formal programs to enhance their knowledge of healthcare IT, software, change management, conflict resolution, process improvement, and the many other disciplines that make the difference between successful projects and failures.

Considering this, it was a rare treat when I had the opportunity recently to attend formal training with our vendor. My last “official” training on our primary system was at least five years ago, and I must say that at that time I had no idea what I was getting myself into. It isn’t as if I’ve had no training since then, but the training that I’ve been able to attend has been very focused – around specialties that are being deployed, planned upgrades, and of course Meaningful Use. There hasn’t been much of an opportunity to really look at the EHR product as a whole and how it’s implemented in our hospital.

As I sat in the training center surrounded by soon-to-be new users, I enjoyed seeing their eager faces and lack of cynicism. It was fun to be the grizzled veteran in the bunch. We went through the applications from the ground up and what I learned was surprising.

Although we are among some of the most robust users on the company’s client list, there is still so much that we’re not using. I quickly learned of a handful of features that could make our providers’ lives easier and also some that would ease the burdens of configuration maintenance. It was also good to network with medical leaders of organizations who are late adopters. They have a very different view of things than those of us who are used to being on the cutting edge, and our after-class conversations were full of great ideas.

It really caused me to think about how we missed finding these items over the past several years. I’ve decided it was because the team was thinking like the IT equivalent of physician subspecialists rather than as primary care specialists. To put it in clinical terms: while we were focused on the musculoskeletal function of the wrist, we missed hearing about the latest and greatest strategies for health promotion and disease prevention. When faced with new features, we may not have understood how we could benefit from them, so we passed them by and never came back to them (usually because our team is running 90 miles an hour with dozens of competing priorities, so I completely understand how it happens.)

I’m encouraging our leadership to plan to fund opportunities for various team members to attend formal training sessions at least every few years so that we don’t find ourselves missing out on features or workflows that could have been beneficial. At the same time, I’m hoping that the experience will give concrete proof to the hospital’s administrators as to why it is important to facilitate learning opportunities for its medical leaders.

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Thanks for shining the spotlight a bit on the need to support and fund professional development and continuing education for clinicians, Dr. Jayne. Many times I have been recruited, hired and paid because I have a clinical background, and yet if this knowledge is not maintained and updated, the organization essentially decreases its return on investment (me!) I typically maintain the CEs necessary for relicensure at my own expense, but find it difficult to locate appropriate courses in the HIT field. Sometimes I can attend sessions at HIMSS, MGMA, etc, but usually am staffing these events so I miss them or must attend pre-conference sessions in my “off time”.
I would like to encourage all vendor organizations to identify their clinical staff and brainstorm how you can leverage the clinicians in your midst and support their professional development. It will pay off in spades and our industry needs this!

If you think it is a challenge for a provider to stay current on the latest (or even the current) uses of an EHR you can imagine how challenging it is to be a patient advocate. Not only do we always pay out of pocket to attend conferences and trainings but we are expected to have the same level of knowledge as providers do.

We rely on a network of patients, providers and implementation consultants (some of us are in the latter category) but in order to stay employable we have to be very careful about discussing various EHR’s.

Frequently when I go to see my own providers or family members I am showing the staff options that they didn’t know existed in their EHR (simple things like graphing a patients BP over time) or linking to patient educational information for surgery.

It is clear that with very few exceptions that most of the recent implementations are not giving the providers the after implementation support that most of the projects I worked on had.. That optimiztion stage is critical to move from the electronic pencil stage to really leveraging the EHR

It is as difficult for the IT and Informatics staff as well. They are pressured to always move on to the next thing and rarely have time to do any optimization planning nor are they allowed to go back to re-train or re-examilne the functionality of the applications post-deployment. Between time and funding, I bet most applications are used for about 50% – 75% of their potential, in not less.

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